The church choir in which I sing is interested in performing "A Child My Choice" by Richard Dirksen, published in 1957 by H.W. Gray Music Company. The piece is now out of print, so I am trying to complete an application for a copyright license through Alfred (current owner of H.W. Gray). However, it looks as though I need an actual copy of the piece in order to properly fill in the application, so I can supply the exact wording of the copyright notice.

My questions are:
-Does anyone have a copy of this piece?
-If so, would you be willing to send me the exact wording of the copyright notice?
-And if my license is approved to make copies, may I use your sheet music to do so?